Case Manager
500 Renaissance Center Detroit, Michigan 48243, Michigan 48075
19-03-2019
- Full time
- $$34.50/per hour
Job Description
Job Title: Case Manager
Location: Detroit, MI
Duration: 12+ Months Contract / Permanent Position
Job Description:
- 2+ years of clinical experience, Case Management Experience, Proficient in MS Office
- The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person-centric care management program to a diverse health plan population with a variety of health and social needs.
- They serve as the single point of contact for members and their families using a variety of digital channels to meet members where they are.
- The Care Manager RN uses the case management process to assess, develop, implement, monitor and evaluate care plans designed to optimize the member's health across the care continuum.
- They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs. This team will work with internal and external partners to maximize impact.
- Use the case management process to assess, develop, implement, monitor and evaluate care plans designed to optimize the member's health across the care continuum.
- Assess the member's health and psychosocial needs and support systems and consider their cultural preferences.
- Engage the member and/or caregiver to develop an individualized plan of care.
- Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services, and disease-specific services).
- Coordinate care delivery and support among member support systems, including providers, community-based agencies and family.
- Deliver education to include health literacy, self-management skills, medication plans, nutrition, weight management etc.
- Monitor and evaluate the effectiveness of the care management plan and change as necessary.
- Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
- Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care.
- Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.
- Assess adherence to care plan and report feedback to necessary stakeholders (e.g., PCPs, caregivers).
- Measure and document the results of the care plan toward meeting members goals.
- Adhere to professional standards as outlined by protocols, rules, and guidelines meeting quality and production goals.
- Continue professional development by completing relevant continuing education and maintaining CMC (Case Manager Certification).
EDUCATION AND/OR EXPERIENCE
- Associates degree in nursing required
- Bachelors degree in nursing preferred
- 2+ years of clinical nursing experience in clinical, acute care, or community setting required
- 1+ year of case management experience in a managed care setting required
- Experience managing patients telephonically preferred
CERTIFICATES, LICENSES, REGISTRATIONS
- Current, active and unrestricted Michigan Registered Nurse license required
- Certification in Case Management (CCM) preferred or to be obtained within 12 months of hire
- Certification in Chronic Care Professional (CCP) preferred
QUALIFICATIONS
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- The requirements listed below are representative of the knowledge, skill, and/or ability required.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER SKILLS AND ABILITIES
- Be a critical thinker with the ability to think outside the box on a large variety of topics
- Strong decision making and problem-solving skills
- Empathetic, supportive and a good listener
- Proficient in motivational interviewing
- Demonstrated time management skills
- Ability to multi-task, while still being thorough when dealing with members
- Must have intermediate computer knowledge, typing capability, and proficiency in Microsoft Word and Outlook
- Must embrace teamwork, but enjoy working independently
- Excellent interpersonal and communication skills both written and verbal
About W3R Consulting
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